title: Left ventricular dysfunction and outcome at two-year follow-up in patients with type 2 diabetes: The DYDA study.
abstract: OBJECTIVE
  Left ventricular dysfunction (LVD) in type 2 diabetes mellitus (DM) (DYDA) study is a prospective investigation enrolling 960 with DM without overt cardiac disease. At baseline, a high prevalence of LVD was detected by analysing midwall shortening. We report here the incidence of clinical events in DYDA patients after 2-year follow-up and the frequency of LVD detected at baseline and 2-year evaluation.
  
  
  METHODS
  Systolic LVD was defined as midwall shortening ≤15%, diastolic LVD as any condition different from "normal diastolic function" identified as E/A ratio on Doppler mitral flow between 0.75 and 1.5 and deceleration time of E wave >140 ms. Major outcome was a composite of major events, including all-causes death and hospital admissions.
  
  
  RESULTS
  During the study period, any systolic/diastolic LVD was found in 616 of 699 patients (88.1%) in whom LVD function could be measured at baseline or at 2 years. Older age and high HbA1c predicted the occurrence of LVD. During the follow-up 15 patients died (1.6%), 3 for cardiovascular causes, 139 were hospitalized (14.5%, 43 of them for cardiovascular causes, 20 for a new cancer).
  
  
  CONCLUSIONS
  During a 2-year follow-up any LVD is detectable in a large majority of patients with DM without overt cardiac disease. Older age and higher HbA1c predict LVD. All-cause death or hospitalization occurred in 15% of patients, cardiovascular cause was uncommon. Independent predictors of events were older age, pathologic lipid profile, high HbA1c, claudicatio and repaglinide therapy. Echo-assessed LVD at baseline was not prognosticator of events.
authors.affiliation: Echocardiography Laboratory, Villa Bianca Hospital, Trento, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioffi
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Donata
authors.initials: D
authors.lastname: Lucci
authors.forename: Aldo P
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Valeria
authors.initials: V
authors.lastname: Manicardi
authors.forename: Augusto
authors.initials: A
authors.lastname: Travaglini
authors.forename: Daniela
authors.initials: D
authors.lastname: Girfoglio
authors.forename: Serge
authors.initials: S
authors.lastname: Masson
authors.forename: Carlo B
authors.initials: CB
authors.lastname: Giorda
authors.forename: Mario
authors.initials: M
authors.lastname: Velussi
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
authors.forename: Paolo
authors.initials: P
authors.lastname: Verdecchia
authors.forename: Marco
authors.initials: M
authors.lastname: Comaschi
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
keywords: Diastolic function; Heart failure; Left ventricular dysfunction; Systolic function; Type 2 diabetes